Clinical presentation of autoimmune hepatitis can be either acute or chronic or totally asymptomatic. The aim of this study was to assess the impact of asymptomatic onset on AIH natural history. Ninety asymptomatic patients were retrospectively compared to 215 with symptoms. Asymptomatic presentation was characterized by lower histological grading and lower mean levels of aminotransferases, bilirubin, gamma-globulins, IgG and anti-dsDNA. On the other hand, asymptomatic patients were more often positive for anti-LKM1 autoantibodies and were more often affected by extrahepatic autoimmune conditions, particularly thyroid and skin disorders. Despite these differences, asymptomatic and symptomatic subjects had similar response to immunosuppressive treatment and comparable prognosis, with a low but considerable rate of progression (23%) towards cirrhosis or its complications.
Claudine Lalanne, Paolo Muratori, Marco Lenzi and Luigi Muratori
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